It’s a bird, it’s a plane … it’s a superbug?!

Are superbugs out to get us? Based on recent reports in the news, this might appear to be the case. Superbugs are bacteria that are resistant to many commonly used antibiotics. There is even a growing population of bacteria that are resistant to last-line antibiotics. These antibiotics are specifically reserved for use in patients infected with bacteria resistant to other antibiotics.

Antibiotic resistance has been on the rise globally. This means there are fewer antibiotic options available for some serious infections. Largely because of the growing threat of antibiotic resistance, a new field called antimicrobial stewardship has evolved.

Bacteria reproduce and spread fast

Bacteria are promiscuous organisms. The speed at which they reproduce allows antibiotic-resistant genes to spread rapidly through bacteria populations. Some bacteria can reproduce in as little as 20 minutes. Often these antibiotic-resistant genes live on a plasmid, a small circular collection of DNA that can easily replicate and pass from bacteria to bacteria.

It’s interesting that bacterial genes carrying resistance to certain antibiotics have been around longer than antibiotics. Bacteria from the ice age harbor some of the same antibiotic resistance genes as bacteria today.

Contributors to antibiotic resistance

There are two major contributing causes to the current rise in antibiotic resistance. One is the widespread routine use of antibiotics in livestock. Large-scale factory farms use low doses of antibiotics in their herds to prevent the spread of disease and to promote growth. Antibiotics are beneficial in fighting infection and disease in livestock, but long-term use is a perfect setup for developing antibiotic resistance. Bacteria that develop resistance then enter the environment and can pass their resistance genes to bacteria that cause human infection.

Currently, there are antimicrobial stewardship policies in veterinary medicine aimed at limiting use and dosage of antibiotics only to animals that have an active bacterial infection.

Unnecessary prescriptions

The tendency of health care providers to over-prescribe antibiotics also has contributed to antibiotic resistance. Antibiotics are only able to kill bacteria; they have no effect on viruses. Yet, they are often prescribed for viral illnesses such as sinusitis and upper respiratory infections.

There are some countries where antibiotics do not require a prescription and are available over the counter. These countries tend to have more antimicrobial resistance. Antibiotics also tend to be over-prescribed in the United States. An estimated 30 to 50 percent of all antibiotics prescribed in the U.S. are unnecessary or inappropriately prescribed.

In 2015, the National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal to reduce inappropriate use of antibiotics in medical offices by 50 percent by 2020. This would be a 15 percent reduction in antibiotic use overall.

Hope for resistance?

Unfortunately, as we are losing the ability to use some of our first-choice antibiotics because of resistance, there are also very few new antibiotics being developed. Pharmaceutical companies lack a financial incentive to do so.

But there is some good news. Superbugs tend to be weaker than other bacteria. If we can minimize superbugs’ competitive advantage by limiting antibiotic use, natural selection will help bacteria less resistant to antibiotics overtake them. Let’s all work together to help fight the rise of superbugs.

What can you do?

There are several things you can do to help limit the spread of antimicrobial resistance:

Buy meat of animals raised without antibiotics.

Ask your provider if antibiotics are truly necessary when given a prescription, and don’t request antibiotics for the common cold.

Write to your congressional representatives asking that they support legislation to expand antibiotic research, and to promote policies endorsing judicious antibiotic use.

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